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1108 E 1st St - Building
Building Permit 1108 E 1St St 13 - 395 okrOlit.t SIGN PERMIT APPLICATION Print in ink /3 3 CJ �'►�►,�� CITY OF PORT ANGELES For City Use Only: Attn: Building Permit Technician Date Received 2/W--/ ?j 321 E. Fifth St., Port Angeles, WA 98362 Permit# /3 y t' (360)417-4815 fax(360)417-4711 ( Date Approved �� �R Applicant or Agent ��J, Atc e.�� Pho a 3(00--(p 13 -`1SSU Property Owner / f-,� , , �'� ��/� Phone Property Owner's Address .//.,1.(,; C'; iL,111 L c, .`"f Ply t ) tQ (- e; Contractor )4a yl So,V 3,' bn 60 Phone oleo --(P13 (16-5-0 Contractor's Address P.0 , Box 9 38 `,,/L)e.►-dale 9k3 e 3 License # /414-Al S G j J I Expires 6---/,e L41/ ,*wa u/,4-/'><</r34z_ 42,1.4 Project Address / % C.-.) F-/=: Business Name / hC KC L f i'c P T Parcel Number C:z(_ , r (s - C4. r�/ ;��,�,� Lot Zoning O 4 Submit an 8 % "x 11 "site plan & three sets of plans that include: ■ Type of sign (wall-mounted, projecting, freestanding, illuminated, other...) • Placement and sq. ft. area • How the sign will be securely attached (Engineering specs may be required for freestanding signs) _ ■ Separation distance between the bottom of projecting and freestanding signs and the surface below See "Chapter 14.36 Sign Code"of the City of Port Angeles Municipal Code for sign requirements. ,„1 i Sian Type& Brief Description: (Type, location, sq. ft) fie,: �o Sign ' ,, = y "as , c,. Sign #2 ..J M _, , . 4 • -LT �t ' �? ``�_ 3/. Sign #3 / /t/U,ene Sign #4 Totals(Unit charges Sign(s) Unit Charge Quantity multiplied by quantities) Type of Sian Valuation$ $47.00 x / = $ ziJ All signs less than or equal to 25 sq. ft. $85.00 x / = $ Wall sign or marquees, over 25 sq. ft. $115.00 x = $ Freestanding sign or projecting sign, over 25 sq. ft. GRAND TOTAL Make Checks Payable to: City of Port Angeles $ Credit Cards (Except American Express)are accepted Existing sign(s) area 6 sq. ft. +Proposed sign(s) area.,15: / sq. ft. = Total sign(s) area,3g..3/ sq. ft. Building façade area (height ; ft. X width VC: ft.) = c!?c sq. ft (If a building has more than one business in it, only measure the area of the building façade that is used by the business applying for this permit) I have read and completed this application and know it to be true and correct. I am authorized to apply for this permit and understand that it is my responsibility to determine what permits are required, and to obtain permits prior to working on projects. Date�Jj/ /1 ,3 Print Name C. , r; II /, t` r1 Signature /,/'C/ /) (// ` K T:Forms/Building Division/Sign Permit Application.doc Untitled http://www.clallam.net/aimsxwebsite/CA public_html nopop/text.htm 1 of 1 4/11/2013 8:42 AM - t - .CITY OF PORT ANGELES DEPARTMENT OF COMMUNITY&ECONOMIC DEVELOPMENT-BUILDING DIVISION 321 EAST 5TH ABET, PORT ANGELES,WA 98362 Application Number 13-00000395 Date 5/09/13 1 Application pin number . . 946555 Property Address 1102 E 1ST ST 'TAX ASSESSOR PARCEL NUMBER: 06-30-00-6-2-0135-2001- REPORT AlSE$ TA/1 1 Tenant nbr, name THERAPEUTIC ASSOCIATES vii a Application type.description SIGNS on your state excise tax foam \I Subdivision Name to the City of Port Angeles Property Use Property Zoning . UNKNOWN (Location Code 0502) Application valuation . . . 0 Application..,desc ILLUMINATED WALL MOUNTED SIGN Owner Contractor HOFF PATRICIA R HANSON SIGN CO INC 1126 COLUMBIA ST PO BOX 928 PORT ANGELES WA 983624208 SILVERDALE WA 98383 (360) 613-9550 Permit SIGN • Additional desc . ILLUMINATED WALL MOUNTED SIGN Permit Fee . . . 85.00 Plan Check Fee . . .00 Issue Date . . . 5/09/13 Valuation . . . . 0 Expiration Date . 11/05113 - Qty Unit Charge Per Extension 1.00 85.0000 PER S-WALL SIGN OR MARQUEE > 25 SF 85.00 - 4 Permit SIGN Additional desc . WALL MOUNTED SIGN ON EAST WALL , Permit Fee . . . 47.00 Plan Check.Fee . . .00 Issue Date . . . 5/09/13 Valuation . . . . 0 Expiration Date . 11/05/13 "....N li' Qty Unit Charge Per Extension 1.00 47.0000 PER S-ALL SIGNS < OR =,TO 25 SF 47.00 Special Notes and CommentscN April 25, 2013 4-:45:06 PM er-oberds. - The proposal will result in a replacement Sign for a total tenant signage of 53 sq.ft. in the CA zone. No land use issues anticipated. f Fee summary Charged Paid Credited Due Permit Fee ?otal 132.00 132.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 132.00 132.00 .00 .00 • *Ovate Permits are required for electrical work,SEPA,Shoreline,ESA,utilities,private and public improvements.This permit becomen null and void if work orconstruction authorized isnO1 cOmmenced wOhlh1.004We,ifecoetruction orw(oni iasuspended"abarliknied 15r a period of 110 days atter the work has ocimmenced,or If niquiredlinlibitkins have not been reqUested within 1,88 days fro n the last inspection.-I hereby certify that I hawed read and examined this application and knowthe same to.be true and correct. Ai pr ions of laws and-ordinances governing this type of work will be complied with-whether specified herein or not;The grand pf* dam not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the. 'the-of constriction. Date Print Name Signature of Contractor or Authorized Agent Signature of Owner(if owner Is builder) , T:Forms/Buiiding Division/Building Permit BUILDING PERMIT INSPECTION RECORD - PLEASE PROVIDE A MINIMUM 24-HOUR NOTICE FOR INSPECTIONS Building Inspecctions 417-4815 Electrical Inspections 4174735 Public Works Utilities 417-4831 Backflow Prevention Inspections 417-4886 IT IS UNLAWFUL TO COVER,INSULATE OR CONCEAL ANY WORK BEFORE INSPECTED AND ACCEPTED. POST PERPMT HIV CONSPICUOUS LOCATION. KEEP PERMIT AND APPROVED PLANS AT JOB SITE. • Inspection Type Date Accepted By Comments • FOUNDATION: Footings Stemvi►aN Foundation Drainage/Downspouts • Piers Post Holes(Pole Bldgs.) PLUMBING: Under Floor/Slab Rough-in Water Line(Meter to Bldg) Gas Line f Back Flow/Water FINAL Date Accepted by AIR SEAL: a \FRAMING: Joists/40,1/Under Floor ShearHold Downs Walls/Rooth (Inter tlallced Panel Only) T INSULATION: Slab Wan/Floor/Ceiling • MECHANICAL: Heat Pump/Furnace/FAU/Ducts Rough-In Gas Line £ Woad Stove/Pellet/Chimney • Commercial Hood/Ducts FINAL Date Accepted by MANUFACTURED HOMES: Footing/Slab Blocking&Hold Downs bidding PLANNING DEPT. Separate Penult 4s SEPA: • Parking/Lighting ESA: Landscaping SHORELINE: FINAL INSPECTIONS R``Q 1 AE PRIOR TO OCCUPANCY/USE .72 • Inspection Type Date Accptrd 8y LIect:icat 417-4735 Construction-R.W. PW /Engineering 417-4831 • Fire 417-4653 Planning 417-4750 • Building 417-4815 T:Forms/Building Division/Building Permit � CITY OF PORT ANGELES �=1 DEPARTMENT OF COMMUNITY & ECONOMIC DEVELOPMENT- BUILDING DIVISION �`r) 321 FAST 5TH STREET, PORT ANGELES, WA 98362 Application Number . . 13-00000395 Date 5!09/13 Application pin number 946555 Property Address 1102 E 1ST ST ASSESSOR PARCEL NUMBER: 06-30-00 6-2-0115-2301- REPORT SALES TAX Tenant nbr, name . . . . . THERAPEUTIC ASSOCIATES Application type description SIGNS on your state excise tax form Subdivision Name . . . . Property age . . . to the City of Port Angeles Property Zoning . . . UNKNOWN (Location Code 0502) Application valuation - Application desc ILLUMINATED WALL MOUNTED SIGN Owner Contractor HOFF PATRICIA R HANSON SIGN CU INC /I/ 1126 COLUMBIA ST PO BOX 928 PORI' ANGELES 14A 983624208 SILVERDALE WA 98383;360) 613 9550gk Permit . . SIGN Additional desc . . ILLUMINATFI) WALL MOUNTED SIGN Permit Fee 85.00 Plan Check Fee . 00 issue Date . . 5!09/13 Valuation . . . . 0 1 �11CA1 Expiration Date . . 11%05/13 , C( w�`/{/ Qty Unit Charge Per Exte.. :)r.;c,:_ 4 ' 1 00 85.0090 PEn -WALT, S1CN CR MARUEE , `IF > CC C` Permit SIGN \\ Additional desc WALL MOUNTED SIGN ON EAST WALL \ Permit Fee 47 09 Plan Check Fe- LI VV Issue Date 5 09:1's dalua_i.n Expiration Date 11/CS/1s Qt',' Unit Charge Per Extension 1.00 4' 0000 PER S ALL SIGNS , OR - TO 2S SF 1' 00 Special Notes and Comments April 25, 2013 4-45-06 PM sroberds The proposal will result in a replacement sign for a total tenant signage of 53 sq._t. in the CA zone, No land use issues anticipated. Fee summary Charged Paid Credited Due Permit Fee Total 132.00 132.00 .00 00 Plan Check Total 00 .00 .00 .00 Grand Total 132.00 132.00 00 00 Separate Permits are required for electrical work,SEPA,Shoreline,ESA,utilities,private and public improvements. This permit becomes null and void if work or construction authorized is not commenced within 180 days,if construction or work is suspended or abandoned for a period of 180 days after the work has commenced,or if required inspections have not been requested within 180 days from the last inspection. I hereby certify that I have read and examined this application and know the same to be true and correct. All provisions of laws and ordinances governing this type of work will be compiled with whether specified herein or not. The granting of a permit does not presume to give authority to violate or cancel the provisions of any state or local law regulating construction or the performance of construction. if ( ' � v•-:" /6/I 1.\-." Xk.),r.'/ € 1L1rt , ;� I. t-ICt.f 4 '( ''.1,J I Date Print Name Signature of Contractor or Authorized gent Signature of Owner(if owner is builder) T:Forms/Building Division/Buddmy Permit PREPARED 6/04/13, 11:57:39 INSPECTION TICKET PAGE 4 CITY OF PORT ANGELES INSPECTOR: JAMES LIERLY DATE 6/04/13 ADDRESS . : 1108 E 1ST ST SUBDIV: TENANT, NBR: THERAPEUTIC ASSOCIATES CONTRACTOR : HANSON SIGN CO INC PHONE : (360) 613-9550 OWNER . . : CLEVENGER, WILLIAM H PHONE : PARCEL . . 06-30-00-6-2-0135-2001- APPL NUMBER: 13-00000395 SIGNS PERMIT: SIGN 00 SIGN REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESU s RESULTS/COMMENTS BL99 01 6/04/13 BLDG FINAL June 3, 2013 10:14:15 AM pbarthol. • Connie 360-613-9550 PERMIT: SIGN 01 SIGN REQUESTED INSP DESCRIPTION TYP/SQ COMPLETED RESULT RESULTS/COMMENTS BL99 01 6/04/13 Jii /0 BLDG FINAL � June 3, 2013 10:12:55 AM pbarthol. Connie 360-613-9550 COMMENTS AND NOTES Certificate of Occupancy 1108 E 1St St 13 -653 CERTIFICATE OF OCCUPANCY City of Port Angeles - Building Division This certificate is issued pursuant to the requirements of Section 111 of the 2012 International Building Code certifying that at the time of issuance this structure was in compliance with the various ordinances of the City regulatingbuilding construction or use for the following: Business name: i Therapeutic Associates Business address: 1108 rE 1St St 6 Business owner: : Therapeutic Associates. ,-, , 9 Business owner's zddress: : 7100 Fort Debt Way Ste 220 Seattle, WA 98188 Automatic fire spi nkler system. N/A h. Use &occupancy?jassification: Business Occupant load: t Per 2012 IBC, Table 1004.1.1 + ; ° a A . -Type of constructio \r 12-05-2014 2014 - .'' r 1 � , gr Date,, R I qGn 'f ;:„, ,-..- ,� Post on the premises in a conspicuous pla1ce ' hiscer ificate shall not be removed except by the Building Official. o<>0' <><> -‘0•PoRr4A,„ CERTIFICATE OF OCCUPANCY APPLICATION Permit#/3 r 53 FEES 1161111111. I CITY OF PORT ANGELES $50 Certificate/Inspection Attn: Permit Technician 321 E. Fifth St., Port Angeles,WA 98362 $100 Parking Business Improvement Area (PBIA) (360)417-4815 fax(360)417-4711 fee charged for Downtown locations PLEASE PRINT IN INK Check one: New business in P.A.?❑ Change of ownership only? Moving location from within P.A.? 4 Zoning BUSINESS NAME Fax/WI-0( nrSecifro /''Y5 it vt 1-k-'K4r'y -- to ar Iej Business address I/Q Y I` Sr- five- Mailing address SA'►"►F Phone number Z bO - tZ- b LI le Opening date 5-itin Days&hours of operation M—F 7.`oo " _?t Business owner's name Ttie 1 C 41TOC I411'' ttit- Contact phone 6 -Li.h/ - for Business owner's address 7100 NO' Po`-/- E&17 Sy t 7F 22-0 StulT 'E, Y fll8� Brief description of business /I i C►tt '/ <tnp IC t7 ft.,7/MSi V"+cx� Property owner's name 714-c-k- 4 r•AY SI a- 4-1-evek4EXContact phone 3 66 --'+to —003'7 Property owner's address/contact Oft i A- tt*3 cwt • BUILDING DEPARTMENT phone 417-4815 Bldg approval by on �/ Is the business a restaurant or bar that will seat 50 or more people? Yes LI No L� Construction changes planned (moving walls, adding/enlarging windows or doors, roofing, siding,foundation work, adding/altering stairways, ramps, bathrooms, electrical, heating/cooling/ventilation systems, etc). Work planned: FIRE DEPARTMENT phone 417-4653 Fire approval by on Changes to a fire sprinkler system or fire alarm system? Yes ❑ No IY/ Work planned: PBIA (Parking Business Improvement Area-Downtown) phone 417-4623 Square footage of business? 5/ I Lt 6 PBIA notified on Is business moving within the PBIA? Yes LI No V CITY CLERK phone 417-4634 ^/ City Clerk approval by on Second-hand dealer/pawnbroker business?Yes C 1 No L'K Will there be dancing at this business?Yes ❑ No A City of Port Angeles Business License is required for: Taxi, Peddlers, Second-Hand Dealer, Pawnbroker, Dance, Hotel-Motel, Fireworks, Ambulance, and Tattoo Businesses. Page 1 of 2 COMMUNITY&ECONOMIC DEVELOPMENT phone 417-4750 CED approval by on Number of off-street parking spaces available for employees and customers? 1)— (A parking plan may be required.) Signs? (wall-mounted,freestanding, projecting, awning, A-frame, etc?) Signs planned- L /SI.tiJ 1) MO i .l r Sit la CSN )15113k' Are aA-rbi+tk-" t'-f1 F i'z SaiC - (�£T+ "pp_o4 .Py C C r'r PLEASE NOTE: NO flashing,intermittent,or chasing signs are permitted in the City of Port Angeles. PWE approval by on PUBLIC WORKS DEPARTMENT-ENGINEERING phone 417-4812 Is site work planned (new or re-located sewer or water service, excavation, grading or filling,work in City right-of-way, new driveway openings, site drainage, parking lots, dowlnns outs, irrigation system backflow devices, etc.). Yes ENo L Work planned: PUBLIC WORKS WASTEWATER phone 417-4845 PWW approval by on Will waste, other than domestic household waste, be discharged into the sewer system? Yes L7 No Yr... If yes,what will be discharged: Call for Certificate of Occupancy inspections BEFORE opening business. Building Department Inspection 417-4815 Fire Department Inspection 417-4653 Please sign up for utility services at the cashiers' counter. I hereby apply for a Certificate of Occupancy. I acknowledge that I have read this application and state that the information I have supplied is correct to the best of my knowledge. Incorrect information may result in revocation of permit. Date [l i3b3 Print Name R-1 rws Signature Dig cat!k OF- j OL iJlfJ T:\Forms\Building Division\Certificate of Occupancy Application(2010).doc Page 2 of 2 Cay OF PORT A-NGELES ftRMrr A-PrucAITON RECE, Building,DMsionlE,jectdcal Inspecdo"s VED 321 East Fifth JUIV I Street-P-0-BOX 1150/Port AnVies Washington, 2013 Ph; (360)41.7-4735 jFa, ,K.- (360)417-4711 Date: / Jk-5�� NSPECIYONS Mulfi-Family or Commercial* -L Commercial Addition I_A Ltera n Plan Review May Be Re! Wfired,please Co late Ele�tjcqj p jio-,/Remodel/Repair* Job Addrm-,.. /-/ ��, Z;,- fan Review Information Sheet Building Square Footage! Descriourt of above Owner 1 0 ation Name;-Jne7-11 Y/ Contmclo-ir Information NBrnen A 0 Zip: state: Mailing cl Fax State: Zip: I License l Ex Phone;'ILn-- - 70 Fax: la� -Iteni - License#/ I-72� ServIce/Feader 200 Amp. Un it ca n P Total 201-400 Amp, $13ZOO ftft $160.00 SelviWFeeder 401-600 Amp SorvicalFeeder 6014000 Amp. $225.00 $288.00 Service Feeder over 1000 Amp. $410,00 $ Branch Circuits 1-4 -W1 Service f=eeder Sraw,h Circuit $ Koo Branch Circuit WIQ Service Feeder $ i"00 Each Additional Br anch Circuit $ 74.00 $ Temp.Service/Feeder 200 Amp $ 5,00 Temp,Service/Feeder 201 $102-00 400 Amp, $121.00 Temp.ServIce/Feede!r 401.600 Amp, $164.00 Temp,ServWFeeder 601-10DO Amp. $185.00 Portal to Portal Hourly $ 96.00 Sign/Outline Lighting $ 88.00 Signal CIMU(U Limited Energy-Muitf-Family $ 64.00 $Algnai C4rtdV Umited Energy!First 1500 sf,commerdal $ 96.00 We' $540 for each additional 1500 sf Renewable Efectdc4l Energy-5KVA System or Less $113,00 Thermostat $ 56.00 $ Ti Vial Owner as deflned by ROW,19.2&281:(1)Omer will occupy the structure for two years after this electrical permit is finaliZed.(2)Ovner is required to hire an electrical contractor if above Said properly is for sale,rent or lease.Permit expires Oftr six Months of last inspection, ��oe swement,I hefeby cet Ihat I am�a owner of the above named,property or a licensed electrical conlracl or.I am making � CoMplianCe Wb$8 ejac�cal IaW�N,E,C,,RCW,Chapter 19,28,WAC-Chapter 296-46B, 'lie City of POrt ot In pAMC 14,05,05D MOM Electrical PerMit ApplicatiOns, Mid 13 chKk Roll. 7 4,1. A A I Or A�. ELECTRICAL PERMIT CITY OF PORT ANGELES 360-417-4735 Application Number . . . 13-00000633 Date 6/11/13 ,Application pin number . . . 615526 1iDn"4 Property Address . . . . . . 1108 E IST ST REPORT SALES TAX ASSESSOR PARCEL NUM2 n; 06-30-00-6-2-0135-2001- Application type description ELECTRICAL ONLY on your excise tax form subdivision Name . . . . . to the City of Port Angeles Property Use Property zoning . . . . . . . UNKNOWN (Location Code 0502) Application valuation , , . . 0 Application desc 1-4 circuits exit lights Owner Contractor ------------------------ ------------------------ CLEVENGER, WILLIAM H SIMPSON ELECTRIC & JOHN GRAY 243036 W HWY 101 PO BOX 669 PORT ANGELES WA 98363 PORT ANGELES WA 983620120 (360) 457-9270 _____Permit----'- , ELECTRICAL ALTER COMMERCIAL Additional desc 1-4 CIRCUITS Pf°+fS1 Permit Fee . . . 86,00 Plan Check Fee .00 �J '✓ Issue Date . . . . 6/7.7/13 Valuation 0 Expiration Date 12/08/13 Qty Unit Charge Per Extension BASE FEE 86.00 - ------------------------ .------ Fee summary Charged Paid Credited Due ----------------- - --- ----- ------ ---------- permit Fee Total. 86.00 86.00 00 .00 Plan Check Total .00 .00 .00 ,00 Grand Total 86.00 86.00 .00 .00 INSPECTION TYPE DATE: RESULTS: INSPECTOR: DI'T'CH SERVICE ROUGH-IN FINAL COMMENTS: �. �, ' PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION Signature of owner or Electrical ContracWr X Date: G:\F-XCI-IANGEIBUILDING RECEIVED,` CM OF PORT T A►NGIi,US PrCR MI T A P]P`LIC,A T ION Building Drvision/Clectt;cal In-,;pec€ians MAY 'j 2013 321 Fast Fifth Street—P.O.Box 11.50/Play:Angeles Washington,98362 ELECTRICAL 'a Ph: (360)417-47,35/Fax; (360)417-54711 BNSPECTiONS -ij Multi-Family or Commercial' )Q-Commercial Addition I Alteration I Remodel 1 Repair" "Plan Review May Be R�gaired Please Complete P ctrical Plan Ravi w I fomrtation Sheet Job Address: __/_/d l" / Building Square Footage: Description of above Owner inf all Contractor Information Name; Name: - solq ��I rr LL—L. Melling A res ; o Mailing Addr ss:,�,,,,V car: State: T.tP fiP city: -�. Stater_Zip.w Fhono,, Fax: Phone:, Q Fax:. License#1 Exp, L;censa V 1~xp. Im�?5 km Unites Total Pit �f!Fed by Unit Charge} Service/Feeder 200 Amp. $132.00 $ Sendceifteder 201-400 Amp. $160.00 Service/Feeder 401.600 Amp $24,00 $ SonftalFeeder 601-1000 Amp. $296.00 a ServlcetFeeder over 1000 Amp. 5410.00 Branch Circuits 1.4 $ 86,00 Branch Circuit WI Service Feeder $ 5.00 Branch Circuit W/0 Service Feeder $ 74.00 Each Additional Branch Circuit $ 5.00 Temp.Service/Feeder 200 Amp. $102.00 q__._____- Temp.Service/Feeder 201400 Amp. $121,00 Temp,ServicelFeeder 401.600 Amp. $164.00 is Temp.Service/Feeder 601-1000 Amp. $185.00 g Portal to Portal Hourly $ 96.00 5_ _ . - SignlOutline Lighting $ 88.00 $ Signal Cincultl Limited Frrergy—Mull/-Family $ 64A0 Signal UrcuiV Limped Energy 1 First 1500 sf•-Commercial 6 96.00 Note: $5.00 for each addilional1$00sf Renewable Electrical Energy-5KVA System or Less $113.00 $_ _ Thermostat $ 56,00 S Total Owner as defined by RCW19,28.261:(1)Owner will occupy the structure for two years after this electrical permit is finalized. (2 Owner is required to hire an electrical contractor if above said property is for sate,rent or lease.Permit expires after six months of last inspection. After reading the above statement,I hereby cerlif that I am the owner of the above named,property or a licensed electrical cant actor.I am malting the electrical installation or alteration in compliance with the electrical laws,N.E.C.,RCW.Chapter 19.28,WAC.Chapter 29646 I3,The City of Part Angeles Municipal Code,and Utility Specifications and PANIC 14.05.050 regarding Electrical Permit Applications, Sign of owner,electric t ontractor or electrical aft lolstrator. ❑ Cash 0 Chock A Credit Card#�_ am \1�/� UAMrI: �1�`-'J� O�Itl9f2t112 ELECTRICAL PERMIT CITY OF PORT ANGELES ! 360-417-4735 Application Number , . , 13-00000491 Date 5/09/13 --+ Application pin number 599631 Property Address . . . . . 1108 E 1ST ST REPORT SALES TAX ASSES,9CR PARCEL NUM3E2: 06-30-00-6-2-0135-2001- on our excise fax form Application type description ELECTRICAL ONLY Y Subdivision Name . . . . , . to the City of Port Angeles Property Use , , . (Location Code 0502) Property Zoning , . . . . . . UNKNOWN Application valuation . , . , 0 Application desc 1-4 circuits treadmill ° Owner Contractor ------------------------ ------------------------ CLEVENGER, WILLIAM H SIMPSON ELECTRIC & JOHN GRAY 243036 W HWY 101 PO BOX 669 PORT ANGELES WA 98363 PORT ANGELES WA 983620120 (360) 457-9270 Permit . , . , , . ELECTRICATu ALTER COMMERCTAT Additional desc 1-4 CIRCUITS Permit Fee 86.00 Plan Check Fee 00 Issue Tate 5/09/13 Valuation . , , . 0 Expiration Date 11/05/13 Qty Unit Charge Per Extension BASE PEE 86.00 ------------------------------------------------------------ - --- -- ---- -- ... Fee summary Charged Paid Credited Due Permit Fee Total 86,00 86.00 00 .00 Plan Check Total. .00 .00 .00 00 Grand Total 66.00 86,00 00 .00 INSPECTION TYPE DATE., RESULTS: INSPECTOR: DITCH SERVICE ROUGH-IN FINAL _zXV COMMENTS: PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: G:IEXCHANGEIBUILDING ELECTRICAL PERMIT CITY OF PORT ANGELES 360-417-4735 Application Number 13-00000491 Date 5/09/13 Application pin number 599631 Property Address , . . . . 1108 2 1ST ST REPORT SALES TAX ASSESSOR PARCEL NUMBER: 06-30-00-6-2-0135-2001- our excise tax form Application type description ELECTRICAL ONLY on y Subdivision Name , . , , , , to the City of Port Angeles Property Use {Location Code 0502) Property Zoning ?7NKNOWN Application valuation . . , , 0 Application desc 1-4 circuits treadmill Owner Contractor CLEVENGER, WILLIAM H SIMPSON ELECTRIC & JOHN GRAY 243036 W HWY 101 PO 'BOX 669 PORT ANGELES WA 98363 PORT ANGELES WA 983620120 (360) 457-9270 Permit. . , . , , , ELECTRICAL ALTER COMMERCIAL Additional deaf 1-4 CIRCUITS Permit Fee 86.00 Plan Check Fee .00 Zssue .Date 5/09/13 Valuation , . , , 0 Expiration Date 11/05/1.3 Qty Unit Charge Per Extension BASE FEE 86,00 Fee summary Charged .paid Credited Due Permit Fee Total 86.00 86.00 .00 .00 Plan Check Total .00 .00 00 00 Grand Total 86.00 86,00 .00 .00 INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE ROUGH-IN FINAL COMMENTS: PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: G:IEXCHANGEIBUILDING 05/20/2019 02:22 FAX 3606139515 HANSON SIGN CO 16002 RECEIVED w MAY . 1 2613 � lirsOrtr,rl.��� E CTRICAl. CITY OF PORT ANGELES PERNIIT APpLIC F�TION 1RSPECTIONS rar- Building Division/Electrical Inspections '+ - 321 East Fifth Street—P.O.Box 11501 Port Angeles Washington,98362 Ph_(360)417-4735 Fax, (360)417-4711 nato: _)�Multi-Family or Commercial* *Plan Review Ma a Re wired,PI ase Complete Electrical Plan Review Information Sheet Job Address; Building Square Feola_ae: Description of above Qwner ormation Contra or Information Name: Name_ 8 Mailing Address: Mailing Ad nss: City Sfate: _7JP: 'r� -- C;ly; Stete: dip: Phone; ax: t Phone �Fax: �ic�:nse#1 Fxp, License#!Exp. Unit Gharae cwt Total(aly Multi lied by Unit Char gel ttem $132.00 - $_ ServiceJFeeder 200 Amp, $160.00 $ SarvicelFeeder 201.400 Amp. $225,00 $ ServicelFeeder 401-600 Amp $286 00 ~� $ $ervicelFeeder801-1000 Amp. $ ServicelFsOer over 1000 Amp, $$410.00 00 $ Branch Circuit W/Service Feeder 7& $ Branch Circuit W10 Service Feeder $ 00 Each Additional Branch Circuit 3 5.00 $ $ranch Circuits 1-4 $ B6.00 $102,00 Temp.Service!Feeder 200 Amp. p $� Temp.Servlcelfeeder201400 Amp. $121,00$124,00 $ Temp.ServicelFeeder 401-600 Amp. 855.00,00 $--- Temp,ServicelFeeder 601-1000 Amp. $$18 Portal to Portal Hourly $ $ as-oa Sign10itline Lighting $ Signal Circuit/Limited Energy T Multi-Famlly $ 64.00 $ Signal Circuit/Umited Energy 1 First 1500 sf Commercial $ 96-00 Note: $5.00 for each additional 1500 sf $ Renewable Electrical Energy-SKVA System or less $113.00 $ Thermostat $ 56.00 Nate:$5,001or each additional T-Slat $ '9�j Total Owner as defined by ROW.1918,261:(1)Owner will is far salehe structure lease,P two expires after electrical zcmanths of last n finalized.�2)Owner is required to hire an electrical contractor if above said property' After reading the above statement,I hereby certify that I am the owner of the above named properly or a licensed electrical contractor.I am making the electrical instailation or alteration in compliance with the electrical laws,N.E.C.,ROW.Chapter 19.28,WAC.Chapter 296468,The City of Part Angeles Municipal Code,and Utility Specifications and PAMC 105.050 regarding Electrical Permit Applications. Signature of owner,electrical contractor or electrical administrator: C caBh ❑ Check CrodltCard# oared, 0�0 v1rvrrzo�2 eau C�>� i ELECTRICAL PERMIT CITY OF PORT ANGELES 360-417-4735 Application Number 13-00000540 Date 5/21/13 Applicat�.on pin number . . . 169980 REPORT SALES TAX Property Address . . , 1108 E 1ST ST ASSESSOR PARCEL NUMBER: 06-30-CO-6-2-0135-2001- on your excise tax form Application type description ELECTRICAL ONLY to the City of Port Angeles Subdivision Name , . . , . Property Use (Location Code 0502) property Zoning' . . . . . . UNKNOWN Application valuation , . . , 0 Application desc Sign Permit Owner Contractor CLEVENGER, WILLIAM H HANSON SIGN CO, & JOHN GRAY' PO BOX 928 "°• PO BOX 669 SILVERDALE, WA. e- PORT ANGELES WA 983620120 SILUERDALE WA 98383 (360) 613-9550 --------------------------------------------------------------- - -- ----- Permit , . , ELECTRICAL ALTER COMMERCIAL Additional desc 00 Permit Fee , , . . 8B4O0 Plan Check. Fee . Issue Date 5/21/13 Valuation 0 Expiration Date 11/17/13 Qty Emit Charge Per Extension 1.00 86.0000 ECH EL-COMM-SIGN 88.00 --- --`Fee summary - - -^ ___ Charged -Paid a Credited -` -Rue - ----- Permit Fee Total 88„00 88.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 68.00 88.00 .00 .00 INSPECTION TYPE DATE: RESULTS: INSPECTOR: DITCH SERVICE ROUGH-IN �?, FINAL COMMENTS: PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION Signature of owner or Electtical Contractor X Date: G:IEXCHANGE\BUILDING 05/22/2013 11:24 FAX 360 452 9265 Angeles Electric 100001/0001 RECEIVED CITY OF PORT ANGELES PERMIT APPLICATION MAY 2 2.013 1 Building D€vision/Electricai Inspections ELECTRICAL 321 East Fifth Street—P.O.Box 11501 Port Angeles Washington,98362 INSPECTIONS "' Ph:(360)417.4735 Fax:(360)417-4711 (� Date: � �/ _Multi amity r Commercial" Commercial Addition!Alteration 1 Remodel/Repair" "Plan Review May Be Required,Please Complete Electrical Plan Review Information Sheet '��� Job Address: Or=r Building Square Footage: Descripgon of above r , Owner Info r anon Contractor Information Name: Name: AAMA& fLdEAT o-g molt MeilEng Ad s: Mail! Address: H Jeis7- City State:�2ip: City a� State; WA-- Zi Phone; ax: Phone; o Fax: License#1 P. Licema#1 Exp Item Unit Chame Qu Total fQ y Multiplied by unit Chargel Service/Feeder 200 Amp, $132.00 $ ServicelFeeder 201400 Amp, $160.00 $ ServicelFeeder 40100 Amp $225.00 $ ServiWFeeder 601-1000 Amp. $288.00 $ Service/Feeder over 1000 Amp, $410.00 $ Branch Circuits 14 $ 800 $ Branch Circuit W1 Service Feeder $ 5.00 $ Branch Circuit WIC Service Feeder $ 74.00 $ Each Additional Branch Circuit $ 5.00 $ Temp.Service!Feeder 200 Amp. $102.00 $ Temp.SerAcelFeeder 201400 Amp. $121.00 $ Temp.ServicelFeeder401.800Amp. $154.00 $ Temp.ServicelFeeder601-1000Amp. $185.00 $ Portal to Portal Hourly $ 96.00 $ Sign/Outline l.ighling $ 88.00 $ Signal Circuit!Limited Energy-Multi-Family $ 134.00 $ Signal Circuit/limited Energy 1 First 1500 sf-Commercial $ 96.00 $ Note: $5,00 for each additional 1500 sf Renewable Electrical Energy-5KVA System or Less $113,00 $ Thermostat $ 56.00 $ $ Total Owner as defined by RCWA9,28.261:(1)Owner will occupy the structure for two years after this electrical permit is finalized.(2)Owner is required to hire an electrical contractor if above said property is for sale,rent or lease.Permit expires after six months of last inspection. After reading the above statement,I hereby certify that I am the owner of the above named property or a licensed electrical contractor.I am making the electrical installation or alteration in compliance with the electrical lays,N.E.C.,RCW.Chapter 19.28,WAC.Chapter 296.468,The City of Port Angeles Municipal Code,and Utility Specifications and PAMC 14.05.050 regarding Electrical Pe it Applications. Signature of owner,electrlcal contractor at electrical administrator: d ❑ check cr.dnca�drr a+� Flt- 2L Dated: [ 0110112012 ELECTRICAL PERMIT CITY OF PORT ANGELES 360-417-4735 Application Number 13-Dg090551 Date 6/03/13 Application pin number , . . 774551 Property Address . .. . , , , 1108 E 1ST ST REPORT SALES TAX ASSESSOR PARCEL NUMBER: 06-30-00-6-2-0135-2001- Application type description ELECTRICAL ONLY on your excise tax form Subdivision Name . . . . . , to the City of Port Angeles Property Use Property zoning . . . . . UNKNOWN (Location Code 0502) Application valuation . . , . 0 - -------- - ---------- Application desc sign circuit Owner Contractor - CLEVENGER, WILLIAM H- ANGELES ELECTRIC & JOHN GRAY 524 E. 1ST ST, PO BOX 669 PORT ANGELES WA 98362 PORT ANGELES WA 983620120 (360) 452-9264 - ------------ ----------------------°------------------------ Permit ELECTRICAL ALTER COMMERCIAL Additional desc . . Sub Contractor . . ANGELES ELECTRIC Permit Fee . . . . 88.00 Plan Check Fee 00 Tasue Date , . . , 5/23/13 Valuation 0 Expiration Date 11/19/13 Qty Unit Charge Per Extension 1.00 88.0000 ECH EL-COMM-SIGN 88.00 Fee summary Charged Paid Credited Due Permit Fee Total 88,00 86100 .00 .00 Plan Check Total OD .00 .00 00 Grand Total 68.00 88.00 00 ,00 'V INSPECTION TYPE DATE:. RESULTS: INSPECTOR: DITCH SERVICE - ROUGH-IN 1 FINAL COMMENTS: PERMIT WILL EXPIRE SIX(6)MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: G:IEXCHANGEIBUILDING ELECTRICAL PERMIT CITY OF PORT ANGELES 360-417-4735 Application Number . . . . . 18-00000147 Date 2/06/18 Application pin number . . . 971786 Property Address . . . . . . 1108 E IST ST ASSESSOR PARCEL NUMBER: 06 -30 -00 -6 -2 -0135 -2001 - Application type description ELECTRICAL ONLY Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . . COMMERCIAL ARTERIAL Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc Replace heat pump ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ CLEVENGER, WILLIAM H DAVE'S HTG & COOLING SRVC INC & JOHN GRAY PO BOX 413 PO BOX 669 PORT ANGELES WA 98362 PORT ANGELES WA 983620120 (360) 452-0939 --=------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL ALTER COMMERCIAL Additional desc . Permit Fee . . . . 56.00 Plan Check Fee .00 Issue Date . . . . 2/06/18 Valuation . . . . 0 Expiration Date . . 8/05/18 Qty Unit Charge Per Extension 1.00 56.0000 ECH ° =LVT-THERMOSTAT 56.00 Fee summary Charged F Paid Credited Due ----------------- -------- `-'?-_•ca ---------- ---------- ---------- Permit Fee Total 56.60 56.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 56.00 56.00 .00 .00 REPORT STATE SALES TAX on your excise tax form to the City of Pori Angeles (Location Code 0502) F INSPECTION TYPE DATE: RESULTS: INSPECTOR-- NSPECTORDITCH DITCH SERVICE ROUGH -IN Y ` l% FINAL,f' COMMENTS: PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: 02/01/2018 12:37PM FAX 3604524376 DAVES HEATING & UUUL1NU CITY OF PORT ANGELES PERMIT APPLICATION Building Division/Electrical Inspections 321 East Fifth Sheet — P.O. Box 1150 I Poet Angeles Washington, 98362 Ph-. (360) 417-4735 Fax: (360) 417-4711 Date'. _ 1 & 2 Single Family Dwelling 1 11 lgjVVV If VVVe- G� j r Plan Review May Be Required, Please Complete Electrical Pian Review Information Sheet Job Address; 1 100 C. Building Square Footage' Description of above i n &-1 l Owner information Name: -'Act- - $,"�t C.(n-ver,�r Contractor Informalign Name: �aVZ1-5 H2O -Ft -n Q"� stn Sr^vc. �rG,r`.' Mali) Add s: 7O •t�bX �+(o'7 Masgng dress �© i5�k �{C:3 City. o 36� City_V tare:TZip Ph6A3�+a�(o0-' hex. Phone:o_ F9z.�3?!r� -M # 1 Exp-_, VES �I � �i a c. t/i9 Item Unit Charge Total (ON Multiplied by Unit Charg service/Feeder 200 Amp. $120.00 $ Service/Feeder 201-400 Amp. $146.00 7 $ 5ervicelFeeder 401-600 Amp $ 205.00 $ Service/Feeder 601-1000 Amp. $ 262.00 $ ServicelFeeder aver 1000 Amp. $ 373.00 $ Branch Circuit W/ Service feeder $ 5.00 $ Branch Circuit W/O Service Feeder $ 63.00 $ Each Additional Branch Circuit $ 5.00 Branch Circuits 1.4 $ 75,00 $ Temp. Service/ Feeder 200 Amp. $ 93.00 $ Temp, ServicelFeeder 201400 Amp, $110.00 $ temp. SetvicelFeeder401-600 Amp. $149.00 $ Temp. Service/Feeder 601-1000 Amp . $166.00 $ Portal to Portal Hourly $ 96.00 $ Signal CircuiU Limited Energy - 1 & 2 Family Dwelling $ 64.00 $ Manufactured Home Connection $120.00 $ Renewable Electrical Energy - 5KVA System or Leas $102.00 S Thermostat $ 56.00 Note. $5.00 for each additional T-Stat NFW CONSTRUCTION ONLY. First 1300 SWate Ft. $120.00 $ Each Additional 500 Square Ft. or Portion of $ 40.00 $ Each Outbuilding or Detached Garage $ 74.00 $ Each Swimming Pool br Hot Tub $110.00 $ $_-6! .Oy Total Owner as defined by RCW.1928.261: (1) Owner Wit occupy the structure for two years after this electrical permit is finalized. (2) Owner is required to hire an electdcat contractor if above said property is fdr sale, rent or lease, Permit expires after six months of last inspection. After reading the above statement, I hereby certify that I am the owner of the above named property or a licensed electrical contractor. I am makinc the electrical installation or alteration in compliance wAh the electrical laws, N,E.C., RCW. Chapter 1928, WAC, Chapter 2964613, The City of Port Angeles Municipal Code, and Utility Specifications and PANIC 14.05.050 regarding Electrical Permit Applications. Signature of owner, aleotxical contractor or electrical admtnlstrator: ❑ cash © Cheek craditcams Q110112G72 X C1 ELECTRICAL PERMIT CITY OF PORT ANGELES 360-417-4735 Application Number . . . . . 18-00000147 Date 2/06/18 Application pin number . . . 971786 Property Address 1108 E 1ST ST ASSESSOR PARCEL NUMBER: 06-30-00-"6-2-0135-2001- Appl.ication type description ELECTRICAL ONLY Subdivision Name . . . . Property Use . . , . . . . . Property Zoning . . . . . . . COMMERCIAL ARTERIAL Application valuation . . . . 4 Application desc Replace heat pump -=-------------------------------------------------------------------- Owner Contractor CLEVENGER, WILLIAM H DAVE'S HTG & COOLING SRVC INC . & JOHN GRAY PO SOX 413, PO'BQX 669 PORT ANGELES WA 98362 PORT ANGELES. WA 983620120' (360) 452"-0939 - r -------------------------------------------------------------------- Permit . . • • . . ELECTRICAL ALTER COMMERCIAL Additional desc . Permit Fee . . . . 56.00 Plan Check Fee .00 Issue Date . . . . 2/06/18 Valuation 0 Expiration Date 8/05/18 Qty : Unit Charge Per Exte11ion 1:00 56,000.0 PCT EL-LVT-THERMOSTAT 56.00 Fee summary" Charged Paid Credited Due Permit Fee Total 56.00 56.00 .00 .00" Plan Check Total .00 .00 .00 .00 Grand Total. 56.00 56.00 .00 00 INSPECTION TYPE DITCH" SERVICE ROUGH -IN FINAL COMMENTS: DATE: RESULTS: PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X REPORT STATE SALES TAX on your excise tax form to the City of Port Angeles (Location Code 0502) INSPECTOR Date: ELECTRICAL PERMIT CITY OF PORT ANGELES 364-417-4735 Application Number . . . . . 18-00000579 Date 4/20/18 Application pin number . . . 612328 Property Address . . . . . . 1108 E IST ST ASSESSOR PARCEL NUMBER: 06 -30 -00 -6 -2 -0135 -2001 - Application type description ELECTRICAL ONLY Subdivision Name . . . . . . Property Use . . . . . . . . Property Zoning . . . . . . . COMMERCIAL ARTERIAL Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc Replace heat pump ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ CLEVENGER, WILLIAM H SIMPSON ELECTRIC & JOHN GRAY 243036 W HWY 101 PO BOX 669 PORT ANGELES WA 98363 PORT ANGELES WA 983620120 (360) 457-9270 ---------------------------------------------------------------------------- Permit . . . . . . ELECTRICAL ALTER COMMERCIAL Additional desc . . 1-4 CIRCUITS Permit Fee . . . . 86.00 Plan Check Fee .00 Issue Date . . . . 4/20/18 Valuation . . . . 0 Expiration Date . . 10/17/18 Qty Unit Charge Per Extension BASE FEE 86.00 - -- - Fee summary Charged Paid Credited Due ------------------------------------- ---------- ---------- Permit Fee Total 86.00 86.00 .00 .00 Plan Check Total .00 .00 .00 .00 Grand Total 86.00 86.00 .00 .00 INSPECTION TYPE DATE: RESULTS: DITCH SERVICE ROUGH -IN FINAL COMMENTS: PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X REPORT STATE SALES TAX on your excise tax krm to the City of Port Angeles (Location Code 0502) 1 d INSPECTOR: Date: MULTI -FAMILY / COMMERCIAL ELECTRICAL PERMIT APPLICATION Public Works and Utilities Department 321 E. 5th Street. Port Angeles, WA 98362 360.417.4735 ! www.cityofpa.us i electricalpermits@cityofpa.us Project Address: 1108 E 1 st St. Physical Therapy Project Description: Replacement of HP Electrical Hook up ❑ Multi -Family Residential E6 Commercial / Industrial / Public Building Square footage: Name: Clevenger William H & John Gray Email: Mailing Address: PO Box 669 Port Angeles, WA 98362 Phone: Name: Simpson Electric LLC License: SIMPSEL973RQ Mailing Address: PO Box 1086 Port Angeles, WA 98362 Expiration Date: 12/11/2019 Email: dlsimpson5l@gmail.com Phone: 360-457-9270 Item_ Unit Charae Quantity Total (Quantity x Unit Charge) Service/Feeder 200 Amp. $132.00 $ Service/Feeder 201-400 Amp. $160.00 $ Service/Feeder 401-600 Amp. $225.00 $ Service/Feeder 601-1000 Amp. $288.00 $ Service/Feeder over 1000 Amp. $410.00 $ Branch Circuit W/ Service Feeder $5.00 $ Branch Circuit W/O Service Feeder $74.00 $ Each Additional Branch Circuit $5.00 $ Branch Circuits 1-4 $86.00 1-4 $ 86.00 Temp. Service/Feeder 200 Amp. $102.00 $ Temp. Service/Feeder 201-400 Amp. $121.00 $ Temp. Service/Feeder 401-600 Amp. $164.00 $ Temp. Service/Feeder 601-1000 Amp. $185.00 $ Portal to Portal Hourly $96.00 $ Sign / Outline Lighting $88.00 $ Signal Circuit/Limited Energy - Multi -Family $88.00 $ Signal Circuit/Limited Energy/First 1500 sf - Commercial $96.00 $ (Note: $5.00 for each additional 1500 sf) Renewable Elec. Energy: 5KVA System or less $113.00 $ Thermostat (Note: $5 for each additional) $56.00 $ s 86.00 TOTAL Owner as defined by RCW.19.28.261: (1) Owner will occupy the structure for two years after this electrical permit is finalized. (2) Owner is required to hire an electrical contractor if above said property is for sale, rent or lease. Permit expires after six months of last inspection. After reading the above statement, I hereby certify that I am the owner of the above named property or a licensed electrical contractor. I am making the electrical installation or alteration in compliance with the electrical laws, N.E.C., RCW Chapter 19.28, WAC. Chapter 296- 46B, The City of Port Angeles Municipal Code, and Utility Specifications and PAMC 14.05.050 regarding Electrical Permit Applications. 4/18/2018 Andrew P Simpson Aldi-pul�P'Vwnu* Date Print Name Signature (❑ Owner V Electrical Contractor/Administrator) [Electrical Permit Applications may be submitted to City Hall or electricalpermits@cityofpa.us or faxed to 360.417.4711] ELECTRICAL PERMIT CITY OF PORT ANGELES 364-417-4735 Application Number . . . . . 18-80000579 Date 4/20/18 Application pin number . . . 612328 Property Address . . . . . . 1108 E 1ST ST ASSESSOR PARCEL NUMBER: 06 -30 -00 -6 -2 -0135 -2001 - Application type description ELECTRICAL ONLY Subdivision Name Property Use . . , . . . . . Property Zoning . . . . . . . COMMERCIAL ARTERIAL Application valuation . . . . 0 ---------------------------------------------------------------------------- Application desc Replace heat.pump ---------------------------------------------------------------------------- Owner Contractor ------------------------ ------------------------ CLEVENGER, WILLIAM H SIMPSON ELECTRIC & JOHN GRAY 243036 W HWY 101 PO BOX 669 PORT ANGELES WA 98363 PORT ANGELES WA 983620120 (360) 457-9270 ------------------------------------------------------------------=--------- Permit . . . . . . ELECTRICAL ALTER COMMERCIAL Additional desc . . 1-4 CIRCUITS Permit Fee . . . 86.00 Plan Check Fee .00 Issue Date 4/20/18 Valuation . . . . 0 Expiration Date 10/17/18 Qty Unit Charge Per Extension BASE FEE x6.00 ---------------------------------------------------------------------------- Fee summary Charged Paid Credited Due --------------------------------------------------------- Permit Fee Total 86.00 86.00 .00 00 Plan Check Total .00 .00 .00 .00 Grand Total 86.00 86.00 .00 .00 I- , REPORT STATE SALES TAX on your excise tax Form to the City of Port Angeles (Location Code 0542) INSPECTION TYPE DATE: RESULTS: INSrhu i m: DITCH SERVICE ROUGH -IN FINAL ! . COMMENTS: PERMIT WILL EXPIRE SIX (6) MONTHS FROM LAST INSPECTION Signature of owner or Electrical Contractor X Date: